Medication Error Reflection
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Nursing Reflection On Medication Administration
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Reflective Journal On Medication Administration
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Harvard Vancouver Wikipedia Share this Share 0 Words 0 Pages Chapters Line spacing Single Double Register to view the rest of this essay A reflection on personal reminiscence PACUs Drug is prescribed by the physician and is dispensed by the pharmacist, but nurses do have the key job for drug errors in nursing nmc administering medication. Medication errors do occur and are a persistent problem associated with nursing practice. drug errors in nursing what to do The experience described here covers a wealth of challenging issues suggestive of those we as nurses meet in professional practice on a day-to-day
Medication Reflection
basis. This reflection takes me 13 years back in my professional career when I joined Post Anesthesia Care unit (PACU) as a nursing intern. As we all know that the PACU is a high-acuity critical care environment where https://www.nursingtimes.net/have-you-ever-made-a-drug-error/5050838.blog patients are kept to recover in the immediate postoperative period after receiving anesthesia. While commenting on PACU staffing Hicks, R.W., Becker, S.C, Krenzischeck, D, & Beyea, S.C, (2004) said: "PACUs are normally staffed by RNs with a wide range of backgrounds and expertise in areas such as critical care; plastic surgery; and emergency, orthopedic, cardiology, and gynecologic nursing." (p. 414). Internationally nurses are not placed in critical care units until they have at least two years of http://www.ukessays.co.uk/essays/nursing/personal-reminiscence.php working experience in medical-surgical units; however, due to staffing crisis the nursing interns in our setting are placed directly into critical care setting. Hicks, R.W., Becker, S.C, Krenzischeck, D, & Beyea, S.C, (2004) said: "Unique situations exist in the PACU that create additional risk for patients. The complexity of care, the fast-paced nature of the PACU, and the needs of a surgical department to maintain the patient flow among the various pre- and postsurgical areas contribute to the risk for medication errors to occur." Although this incidence is rooted 13 years back it still knocks my heart and soul every day, every night. I still remember it was only a month of my professional career and I was going through "reality shocks" of my staff life. It was a lot busier and the patients were probably sicker than I expected. I didn't realise I'd be looking after sick patients every day, there wasn't actually any let up from it. I had started realizing the uniqueness of PACU world and I was witnessing that nurses working in the PACU were truly at the "sharp end" of care. I had started realizing that PACU nurses are highly vulnerable to error as these nurses were involved in performing various tasks hurriedly. These tasks included, but certainly not limited to ongoing assessment, critical evaluation of patients' responses, verbal and nonverbal communication with
LadyFree28. An Order has been issued by the United States District Court for the District of Minnesota that affects you in the case EAST COAST http://allnurses.com/certified-registered-nurse/lessons-learned-from-475504.html TEST PREP LLC v. ALLNURSES.COM, INC. Click here for more information ➤ Open letter to the allnurses community regarding the Achieve Test Prep Litigation LatestConferences Nursing Specialties › Certified Registered Nurse Anesthetist (CRNA) › Lessons learned from a fatal medication error:-- reflections for CRNA epidural order by NRSKarenRN, BSN, RN Moderator Apr 24, '10 | 15,607 Views | 16 medication error Comments Comment 1 2 Next » 0 From: Agency for Healthcare Research and Quality Shaping systems for better behavioral choices: lessons learned from a fatal medication error. Smetzer J, Baker C, Byrne FD, Cohen MR. Jt Comm J Qual Patient Saf. 2010;36:152-163, 1AP-2AP. This article discusses how a hospital responded to a fatal medication error that occurred when a medication error reflection nurse mistakenly administered epidural pain medication intravenously to a pregnant teenager. Findings from the root cause analysis of the error revealed underlying factors including fatigue (the nurse had worked a double shift the day before), failed safety systems (the hospital had recently implemented a bar coding system, but not all nurses were trained and workarounds were routine), and human factors engineering (bags containing antibiotics and pain medications were similar in appearance and could be accessed with the same type of catheter). A range of safety interventions were implemented as a result. However, the related editorials by leaders in the safety field (Drs. Sidney Dekker, Charles Denham, and Lucian Leape) take the hospital to task for focusing on narrow improvements rather than using complexity theory to solve underlying problems, and for creating a "second victim" by disciplining the nurse (who was fired and ultimately criminally prosecuted) rather than acknowledging the institution's responsibility and the caregiver's emotional distress. The article and commentaries provide a fascinating, in-depth look at the true impact of a never event. Full text: http://p